Fracture reducing apparatus



June 16, 1942. E. F. LONGFELLOW 2, 5

FRACTURE REDUCING APPARATUS Filed 'Marh 2, 1940 2 Sheets-Sheethl X was \E June 16, 1942. E, LQNGFELLOW 2,286,556

FRACTURE REDUCING AljPARATUS Filed March 2, 1940 2 Sheets-Sheet 2 Patented June 16, 1942 .Ea-rl .E. Longfellow, Warsaw, Ind., assignor to Harryf H. Leiter, Warsaw, Ind.

Application March 2, 1940,;SeriaLN'o. 321,863

-8 Claims.

The presentinvenl-ion relates to surgical apparatus and more particularly to fracture reducing apparatus.

One of the objects 'of the present invention is the provision of a fracture reducing apparatus that is adjustable to meet various-conditions of use in applying traotive force to and maintaining proper location of the fractured parts .of a patients arm and shoulder during the application of splints, bandages or casts, and which is so constructed and arranged that fluoroscopic, therapeutic and other apparatus may be readily used therewith.

In my-copending application Serial No. 217,230, filed July 2, 1938, (Patent No. 2,232,952 granted February 25, 1941), there is disclosed fracture reducing apparatus adapted removably to be secured to a table or the like, and adjustably to support the body of a patient, and provided with structure whereby traction may be applied to the legs of the patient. The apparatus'is constructed so that it may be readily mounted on conventional forms of hospital and'examining tables.

It is one of the'objects of the present invention to provide apparatus of the-type described in the above mentioned copending application with readily removable and adjustable structure for applying tractive force to the arm and shoulder of a patient.

A further object of the present invention is to provide fracture reducing apparatus whereby external rotation and extension of the humerus may be effected and counter traction applied on the forearm.

A further object of the present invention is to provide an apparatus of the typedescribed which is adapted for use particularly with the apparatus disclosed in the copending application, but which may be used independently thereof.

Other objects and advantages of the present invention will become more apparent from the ensuing description in the course of which reference is had to the drawings, in which:

Fig. l isa fragmentaryperspective view of the fracture apparatus of the present invention;

Fig. 2 is a partial sideelevationof the apparatus shown inFig. l withparis thereofshownin diilerent positions of adjustment from the posi tions in which they are shown in Fig. 1;

Fig. 3 is a fragmentary top plan view looking at the apparatus in the direction of the arrows 3-45 of Fig. 1;

Fig. 4 is a fragmentary side elevation, partly in section, of the apparatus shown in Fig. 3;

Fig. 5 is .averticalcross sectional view taken on the line 5-5.of Fig. 1.

Referring now to the'drawings and more particularly to Figures .1 and 2, the apparatus of the present invention is there shown secured to a table It] supported in suitable manner upon a bed l2.

Removably secured to the table are main and auxiliary supports, indicated generally by reference characters 14 and t6, the formerincluding a pelvic support 18, a perineal supportZll, a pair of sling supports 22 and leg traction bars 24; and the latter aback restZB and ahead rest28. The structure referred to-generally above isdisclosedin the previouslymentioned co'pending application, but in'order that a better understanding may be had of the present invention, it is deemed advisable to describe it briefly.

The main support comprises a rectangular metal base plate 30 centrally of which is suitably mounted a flanged support 32. A double T-coupler -34is secured to the support and to the latter is secured a vertical post 36. The pelvic and perineal supports 18 and '20 are placed on the post above the coupler.- These supports are so constructed and arranged that when in their lowermost positions, in which they are indicated, theyarenon-rotatable with respect to each other and the post, but are rotatable with respect to each other and the post when lifted slightly. The sling supports 22 are likewise mounted on the post-and are adjustable angularly and vertically and are secured in adjusted position by suitable means such as thumb screws 38.

'Thedouble T-coupler is provided with dlametrically opposite laterally-extending arms lii, each provided with a number of spaced apart apertures 42. The traction bars 24 are adjustably mounted for pivotal movement in these apertures by bolts and Wing nuts '44 (only one of which is-shown in Fig. 1') -so that the pivot points of the traction bars may -be-broughtinto alignment with the -patients hip' joints.

Telescopic extensible struts 46 are also secured to the double T-coupler 34 by means of acoupling member 48. The opposite ends of the struts (which are not shown) areadjustably secured to the traction bars 24.

The base plate 30 is adjustably secured to the table ID by two clamping means, each of which comprises a pair of relatively movable slotted strips 50 and 52 which may be secured in adjusted position by screws 54. Each strip terminates in an inverted U-shaped portion 56 having a downwardly extending table engaging portion 58. Adjustment of the clamping means is effected .by thumb nuts 60 mounted on threaded members 62 extending through the U-shaped ends of strips 52 and arranged in telescopic relation to tubular members 64 extending through the U-shaped ends of strips 50. The threaded and tubular members 62 and 64 are held in fixed relative position by clamps 66. A felt pad 68 is placed between the plate 30 and the table in order to prevent marring of the latter.

The auxiliary support I6 comprises a base plate 10 similar to base plate 30 secured to the table in a manner identical to the latter. In view of the identical nature of the securing means, the securing means for the auxiliary support will not be described in detail.

The back rest 2 6 is secured substantially centrally of base plate ID by elevating means comprising a rotatable bolt I2 and a linkage system, indicated generally by reference character 14. The head rest 28 is secured directly to the back rest and is movable as a unit with the latter. The back and head rests are preferably covered with felt or other cushioning strips I6 and I8, respectively.

Returning now to the invention forming the subject matter of the instant application, reference will again be had to Figs. 1 and 2. The reducing apparatus comprises a tubular traction bar 80 flattened at one end as indicated by the reference character 82 see Figs. 1, 3 and 4. The bar is removably attached to the base plate I and is mounted on the latter for pivotal movement in a substantially horizontal plane by means of a pin 84-" (see Fig. 4) secured to the reduced end portion of the bar as by riveting or welding. A tubular post 86 receives the pin 84. This post is fixedly secured to a flange supporting member 88 removably secured to the base plate I0 by a pair of bolts and wing nuts 90 and 92, respectively. In order to permit the post and traction bar to be mounted on either side of the base plate 10, the opposite ends of the latter are provided with a pair of parallel slots 94 through which the bolts 90 extend.

The traction bar may be adjusted angularly by reason of the pivotal mounting provided by the pin 84 and associated post 86. The bar is maintained in adjusted position by means of a telescopic strut, indicated generally by reference character 96, comprising a tubular portion 98 and a rod portion I00. The tubular portion is pivotally mounted on one or the other of the laterally extending arms 40 by means of a bolt and wing nut I02 extending through the fiattened end of the tubular member and through the arm. The rod portion is pivotally secured to the traction bar 80 by a two part clam-p I04 and cooperating bolt and wing nut I06. The two parts of the strut are maintained in any selected adjusted position by clamping means comprising a bolt and wing nut I08, the bolt of which passes through integral extensions IIO formed on opposite sides of a slot formed at the end of the tubular member 98.

The above described construction not only provides for the pivotal movement of the traction bar and rod member I00, but also provides for the longitudinal adjustment of the clamp I04 along the traction bar 80.

Traction applying means comprising a post I I2 is mounted for rotary and longitudinal movement relative to the traction bar 80. The post is formed with a clamping portion II4 connected by a hinge IIB to the lower end of the post as best shown in Fig. 5. The post is secured to the bar by a bolt II8 extending through the post and clamping portion H4. The bolt II 8 terminates at one end in a return bend I20 and is threaded at its opposite end I22 so that the post may be tightened by means of a thumb nut I24.

Traction may be applied by a hook I26 selectively mountable in any one of three sets of openings I28 formed at the free end of post H2. The hook is threaded at one end and provided with a thumb nut I30 so that the hook may be moved in a direction parallel to the traction bar.

Rotation of the humerus and counter traction upon the forearm may be effected by means comprising a generally U-shaped frame I32 also mounted for rotary and longitudinal movement with respect to the traction bar. The frame is adjustably secured to the bar by a tubular clamp I34 welded or otherwise secured to the transverse portion of the U-shaped frame. The clamp has associated therewith a hand nut I36 operable to secure the frame in its various positions of adjustment.

The U-shaped frame comprises a tubular intermediate portion I38 located, as shown in Fig. 1, directly above the traction bar 80 and formed integrally with a lower transverse Portion I40. The frame also comprises an upper rod I 42 of generally rectangular cross section telescopically arranged with respect to the tubular portion I38. This upper portion is maintained in adjusted position with respect to the tubular position by means comprising the bolt and wing nut I44 extending through integral extensions I46 formed on opposite sides of a slot in the upper end of the tubular portion I38. The portions I40 and I42 are bent to provide the parallel hook-receiving portions I50 and I52. These are apertured, as indicated by reference characters I54, so that the traction-applying hooks I56 and I58 may be properly positioned thereon.

In order properly to position the patient, when applying traction, a side rest I60 is secured to the back rest 26 by a pair of wing nuts I62. The side rest is so constructed that its position may be reversed in case the traction bar 80 and associated apparatus are mounted on the side opposite the table on which they are shown in Fig. 1. The rest is located with its armpit engaging edge substantially over the pivot point of the traction bar, as illustrated best in Fig. 2.

In the use of the fracture reducing apparatus disclosed, the upper support post 36 and perineal support 20 may be removed to increase the ease of placing the patient upon the table and are replaced in the indicated positions after the patient has been properly located. The patient is first placed so that the pelvic support supports the patients pelvis; the leg supports (not shown) associated with the leg traction bars 46 properly support the patients legs, and the back and head rests support the patients back and head at a height determined by the adjustment thereof. In case it is desired to utilize the leg fracture reducing apparatus only, this can be accomplished readily after the manner disclosed in the previously mentioned copending application.

When it is desired to utilize the arm and shoul der fracture reducing apparatus, the patient is placed on the apparatus in the manner previously described. In case it is desired only to apply traction either to the forearm or humerus, or shoulder, the patients arm is suitably connected by a tractor to the hook I26 which may be rotated with respect to, or moved along the traction bar 80 by manipulation of post H2. Generally speaking the post occupies a position corresponding to that shown in Fig. 2. From Fig. 2 it may be noted that the hooks I26, I56 and I58 are substantially in alignment in a vertical plane when the post and frame are in their horizontal and vertical positions, respectively. The traction bar 80 may likewise be moved into the desired angular position with respect to the patients body by reason of its pivotal mounting on the base plate 10.

One of the advantages of the described construction resides in the fact that skin, strap or skeletal traction may be used with equal facility.

In case it is desired to apply counter traction to the forearm, use is made of the hooks I56 and 58 mounted on the frame I32. This frame, it may be remembered, is also rotatable with respect to and movable longitudinally of the traction bar 80, the rotation of the frame enabling the humerus to be rotated if this is required.

From the preceding description, it should be noted that one of the features of the present invention resides in the fact that it may be readily combined with the leg fracture reducing apparatus of my copending application so that fractures of the legs and arms of the patient may be treated without moving the patient from the apparatus.

A further advantage is that the arm fracture reducing apparatus may be removed from the table while working on the patients legs, or if desired, different surgeons may work on the legs and on the arms at the same time.

A further advantage of the present invention resides in the fact that the arm reducing apparatus is usable separately from the remainder simply by mounting it upon a separate table, provided with a suitable post for supporting the traction bar 80 and with means permitting attachment of the extensible strut 96 thereto.

While I have described and illustrated only one specific embodiment of my invention, I contemplate that changes may be made therein without departing from the scope or spirit of my invention.

.What I claim is new and desire to secure by United States Letters Patent is:

1. A fracture reducing apparatus including in combination, a traction bar, means supporting said bar for pivotal movement in a substantially horizontal plane, means for maintaining said bar in adjusted positions, means for applying traction in a direction generally parallel to said traction bar including a post adjustably mounted for rotation about the bar and longitudinal movement along the traction bar, and other traction applying means including a substantially U- shaped frame mounted on said bar intermediate the legs thereof and between said post and the pivot point of said bar, the legs of said U-shaped frame extending away from the axis of the bar, whereby counter-traction may be exerted thereby.

2. A fracture reducing apparatus including in combination, a traction bar, means supporting said bar for pivotal movement in a substantially horizontal plane, means for maintaining said bar in adjusted positions, means for applying traction in a direction generally parallel to said traction bar including a post adjustably mounted for rotation about the axis of the bar and longitudinal movement relative to the bar and a traction applying device movable parallel to the bar, and

other traction applying means including a substantially U-shaped frame mounted on said bar between said post and the pivot point of said bar and having its legs extending away from the axis of the bar, said frame having associated therewith opposed traction applying devices secured to said legs, said legs and post having lengths such that the devices are substantially in the same plane as said first mentioned traction applying device when the post is parallel to and extends away from the traction bar in the same direction as the legs of the U-shaped frame.

3. An arm fracture reducing apparatus, including in combination, a support including apertured arms extending in diametrically opposite directions from said support, an auxiliary support including a base plate and a back rest secured thereon, an arm traction bar pivotally mounted on said base plate for movement in a substantially horizontal plane, and an adjustable strut extending from said bar to one of said apertured arms for securing said bar in adjusted position.

4. An arm fracture reducing apparatus according to claim 3 wherein said base plate is provided with means for receiving the pivotal mounting for said arm traction bar on either side thereof.

5. An arm fracture reducing apparatus according to claim 3, wherein said base plate is provided with means for receiving the pivotal mounting for said arm traction bar on either side thereof, and wherein a side rest is adapted reversibly to be mounted on said back rest.

6. A fracture reducing apparatus including in combination, a traction bar, means supporting said bar for pivotal movement in a horizontal plane, means for maintaining said bar in adjusted positions, means for applying traction in a direction generally parallel to the bar including a post adjustably' mounted for rotation and longitudinal movement relative to the traction bar, other traction applying means including a substantially U-shaped frame mounted on said bar between said post and the pivot point of said bar, said means including opposed devices for aplying counter-traction and a side rest located with its armpit engaging edge substantially directly over the pivot point of said traction bar.

7. A fracture reducing apparatus including in combination, a substantially horizontally disposed bar, a substantially U-shaped frame mounted on said bar at a point intermediate the legs of the U for rotary and longitudinal movement with respect thereto, the legs of said frame extending away from the axis of said bar, opposed traction applying means mounted on said legs, and single clamping means associated with said bar and frame releasable to permit longitudinal and rotary movement of said frame relative to said traction bar.

8. A fracture reducing apparatus, including in combination, a traction bar, supporting means for said bar, means for applying traction in a direction generally parallel to said traction bar including a post adjustably mounted for rotation about the bar and longitudinal movement along the traction bar, and other traction applying means including a substantially U-shaped frame mounted on said bar intermediate the legs thereof and between said post and the bar supporting means, the legs of said U-shaped frame extending away from the axis of the bar, whereby counter-traction may be exerted thereby.

EARL E. LONGFELLOW. 

